Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Gilla999 on August 21, 2021, 09:07:32 AM
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I started on Lenzetto / cyclical Utrogestan in April after suffering from debilitating night sweats and insomnia for two weeks out of every four, for about a year. I am however still ovulating and having regular periods. The Lenzetto has been an absolute dream and pretty much got rid of all my symptoms. I had tried two contraceptive Pills (back to back, no breaks taken) prior to starting Lenzetto which didn't work and actually made me more symptomatic, so to find something that has worked for me has literally been life changing.
However the massive problem for me still is that I gained a large amount of weight in a very short space of time - in total it was 1.5 stone over about 4 weeks, and was gaining about 5-6 pounds a day some points during that time. There was absolutely no change in my eating or exercising and it to me felt like a reaction to something, to gain such an amount of weight in a short space of time. This actually happened just prior to starting HRT in Feb/March, when I was still trying to take the Pill. At the same time I started suffering with chronic constipation - it is really very bad, and nothing I eat or pills I take (prescription or otherwise) make any difference. Doctors don't know what's wrong so have dismissed me.
I have always felt that perhaps this was because my circulating estrogen was too high, firstly with taking the Pill with no breaks and then moving onto two sprays of Lenzetto (I have read high circulating estrogen can cause both weight gain and constipation) so twice I tried lowering the Lenzetto even slightly but failed due to reoccurence of problems. So if it appears that 2 sprays are actually the amount of estrogen I need to be symptom free, I don't understand what could have caused the rapid weight gain and constipation. I had some thryoid tests done that show I am borderline hypothyroid - I'm on the last number of normal before it falls into hypo range - and I have very high antibodies present. I don't know much about thyroid issues but I wondered if anyone here had experience as to whether that could be responsible for the weight gain and chronic constipation, even though it is (only just) still in the normal range? I also wondered if changes to your estrogen levels can cause thyroid issues...?
I'm really confused and no doctors are interested - it's so frustrating as the weight and constipation are the ONLY things stopping me from feeling like I can be back to my old self and I would really like to understand what is causing it!
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Hi Gilla, sorry to know you are having problems with weight gain & constipation on HRT. I'm long term hypothyroid on thyroid replacement & HRT and thyroid conditions can certainly muddy the picture at menopause.
I had some thryoid tests done that show I am borderline hypothyroid - I'm on the last number of normal before it falls into hypo range - and I have very high antibodies present.
I suggest you talk to your GP about having a repeat thyroid function test at an interval he/she thinks appropriate, so that if you are becoming hypothyroid this is picked up sooner rather than later & you can be started on some thyroid replacement. With high antibodies, borderline hypothyroid test results & some symptoms suggestive of underactivity, it does seem possible your thyroid is failing, but only repeat testing will show whether this is the case.
It is possible to have thyroid antibodies without developing thyroid failure & it would be inappropriate to start a patient on lifelong medication if it's not necessary.
I don't know much about thyroid issues but I wondered if anyone here had experience as to whether that could be responsible for the weight gain and chronic constipation, even though it is (only just) still in the normal range?
Weight gain & chronic constipation can be consequences of an underactive thyroid but I'm not sure whether this would explain weight gain to the degree you've experienced in such a short period with a TFT still within range. Sorry, that's not much help, I know.
I also wondered if changes to your estrogen levels can cause thyroid issues...?
Women on replacement thyroid hormones can find their dose needs adjusting to balance with their HRT.
Oestrogen is said to boost immunity & there is debate over the use/effects of HRT in some autoimmune diseases (e.g. Lupus, Sjogren's) but as with all things endocrine the association is complex & I think not that well understood. I haven't seen any research suggesting HRT might be involved in causation of autoimmune hypothyroidism if that's what you're asking, but I do wonder what as yet unidentified effects it might have on those of us with autoimmune tendencies. We can only take what meds are available to treat our symptoms & try to be attuned to what our bodies are telling us, though at menopause with so much changing that can be quite a task!
Wx
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Thank you Wrensong, this is so knowledgeable and helpful! Yes, I had wondered if I had somehow tipped myself into having hypo by increasing my hormones, so interesting to know there is no link there. And you're the second person who has said rapid / sudden and large weight gain would be unlikely to related to thyroid. I spoke to an Endocronologist and he offered to start me on 25mg thyroxine to see how I go but I'm obviously not really wanting to take something unless I have to.
I just don't understand what could account for such a rapid amount of weight gain and constipation - both the things came together. I can't even blame the HRT specifically because it happened before that, at the end of a 5 month trial period of back to back contraceptive Pills.
Has anyone else experienced a lot of sudden weight gain in relation to taking HRT or contraceptives? It just seems strange that I would experience it and yet clearly need that level of estrogen because if I don't I'm symptomatic with night sweats and insomnia :-\ No amount of dieting or exercise makes any difference at all - it feels like something has happened to my metabolilsm that's made it ground to a halt. I'm not even feeling hunger in the same way as I used too - all so confusing!
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Hi again,
I just don't understand what could account for such a rapid amount of weight gain and constipation - both the things came together. I can't even blame the HRT specifically because it happened before that, at the end of a 5 month trial period of back to back contraceptive Pills.
BCP could have a similar effect to HRT in terms of potential for fluid retention contributing to weight gain & could also be implicated in constipation - all gynae hormones after all.
it feels like something has happened to my metabolilsm that's made it ground to a halt. I'm not even feeling hunger in the same way as I used too
I do really notice the effect on slowing of metabolism when I need to increase my thyroid medication & being backed up does reduce appetite.
Can I ask do you have any other symptoms of low thyroid, such as feeling disproportionately cold for weather conditions, unusually poor stamina, loss of outer section of eyebrows? Also are you finding you're passing less water than you used to?
Wx
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Coldness not really - i tend to swing between too cold and then too hot! Stamina 100% yes but I had put that down to the weight gain. I've always had a problem with frequent urination but I have noticed that I'm struggling to go now - as in, i still have a frequent urge but it feels like I can't get it out and I'm not emptying my bladder properly (I'm not sure if that's what's you meant?).
If it isn't my thyroid and is in fact the hormones it just doesn't make sense to me that i would need this level to be non symptomatic and yet it would cause such strong side effects with it. The only other change is that my cortisol is consistently out of range / high throughout the day - that started at the same time as the weight gain and constipation and I've no idea what would have caused that or how to address it (I don't feel stressed or anxious at all!).
I really appreciate your thoughts on the thyroid thing as I'm not knowledgeable about that side of things at all!
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The thermoregulation difficulty can also be a feature of hypothyroidism, but of course menopause too. I really struggle in both cold & heat. Takes an age for me to warm up & cool down, but then my thyroid replacement is a bit clunky as I need 2 types of thyroid hormone, but that's unusual & most people do really well on thyroxine alone.
With urination, I meant do you notice you're passing lower volumes than you used to - any indication your kidneys are a bit sluggish as that could also result from an underactive thyroid. But difficulty emptying as you describe could be partly mechanical too, tied up with the constipation. And hindered by pelvic floor dysfunction.
High cortisol can result from an underactive thyroid. So constipation, weight gain, high cortisol, poor stamina, possible fluid retention, poor thermoregulation, thyroid function close to bottom ref range & high thyroid antibodies. Beginning to add up a bit. I take it you meant your T4 was low? Was TSH towards top of ref range?
I spoke to an Endocronologist and he offered to start me on 25mg thyroxine to see how I go but I'm obviously not really wanting to take something unless I have to.
If an Endocrinologist who's seen your results has suggested a trial of 25mcg thyroxine he must think it a reasonable course of action & as you're so uncomfortable, with some of the classic symptoms of hypothyroidism, I would give his suggestion some serious thought. Are you able to speak to him again without a formal appointment? Wondered whether maybe he's a colleague or friend. Perhaps more insight into his thinking would be reassuring & help you decide? He should be better placed to advise than your GP, so I'd make the most of the opportunity for expert opinion.
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Yes sorry T4 was low:
T4 = 12 (range 12-22)
TSH = 3.3 (range 0.27 - 4.2)
T3 = 4.4 (range 3.1- 6.8 )
Thyroid peroxidase antibodies = 96 (range 0-34)
Endo sort of "gave me the choice" (as I find docs seem to do these days... except when it comes to HRT of course ;) ) I got the prescription and tried it for two days but then I couldn't sleep, I felt really hyper, so I stopped it. Do you think two days is way too quick to have a response to thyroxine like that? My sleep is so sensitive it is the first thing to "go" so it could have been a number of other things instead but I chalked it up to the thyroxine and stopped it. However I've heard thyroxine takes time to build up in your system so not sure if it was likely to have been that? Perhaps I should give it another try.
You're right on the symptoms list - the only way I can describe it is it feels like something happened to my metabolism and the whole thing has ground to a halt, both with digestion, hunger, energy levels... it felt like something "switched" and I can't understand if this would be likely to be from excess hormones (but if that's the case why reducing would cause me to be symptomatic) or if it could be something else. Wrensong thank you so much for this, it has been extremely helpful! I'm going to give the 25mg another try and see how it goes :) At least then I'll know!
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Hi Gilla999,
I had the contraceptive pill in my mid 20’s for 3 months and gained two stones. I was on my feet all day and working long hours, my daughter was little and I was studying through the night; life was tough. Money was tight and I ate very little.
I don’t remember what the pill was called but I think it was Dianette(sp?). The weight dropped off as soon as I stopped taking it.
Victoria ☀️
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Thanks for posting the TFT results, Gilla, that's very helpful :). As you say T4 is right at bottom range but TSH & FT3 are OK, so it's quite difficult to interpret & to know what to do about the Endocrinologist giving you the choice of whether to start thyroxine, especially as the presence of TPO antibodies doesn't necessarily mean you will eventually become overtly hypothyroid.
I don't know whether your sleep could have been adversely affected by just 2 days of thyroxine at low dose. You're right it takes time to exert full effects but if you are sensitive to medication & already struggle with sleep & your TSH & FT3 are OK so thyroid supplementation may not be what you need right now, then I wouldn't rule out that it could have been responsible.
Can I ask what time of day you took the thyroxine? And was it during the Utrogestan phase of your cycle? Do you usually sleep OK on Utrogestan or does that make you feel a bit hyper? I ask because it makes me feel very revved up & worsens my insomnia. Sorry for so many questions, please don't feel obliged to answer anything you're not comfortable with.
Your sense of a much slowed metabolism certainly squares with an underactive thyroid, but in spite of the low T4 your TSH & FT3 are OK, so like you I'm really not sure we can assume such sluggishness can be entirely attributed to what may or may not be going on with your thyroid. That said, I do find even transdermal oestrogen increases my requirement for thyroid replacement so maybe if your thyroid is under par you are feeling additional effects from the oestradiol in your HRT, but don't quote me on that, I'm just thinking out loud & trying to make sense of the way you feel.
Crumbs Gilla, what a pity the Endocrinologist didn't lean one way or the other, but I expect he's just as unsure. I don't know what to say & don't want to sway your decision. I think as you suggest, if you want to try the thyroxine again, maybe start during the oestrogen only phase of your cycle. Ruling out any potential influence from Utrogestan might help you gauge whether it was the thyroxine responsible for the hyper feelings & sleep disturbance.
Wx
P.S. was writing this while you were posting, Victoria. What you say is very interesting in light of Gilla's situation.
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I don't mind the questions at all, I'm grateful to have someone to mull it over with as it's such a strange one. I know that something has caused it, I just have absolutely no idea what. I've been on the contraceptive pill (many of them, including Dianette) and never gained 1.5 stone from them and had this terrible constipation (and of course now I'm on HRT and not the Pill) so I'm not really sure how that could be to blame - especially as I have tried to lower my Lenzetto to see if things improve and then I start being symptomatic again.
I took the thyroxine first thing in the morning - I always do that with meds so they hopefully have as little impact on my sleep as possible. Yes it was during the Utrogestan part of my cycle. Utrogestan 100mg vaginally I cope completely fine with with no side effects but when I have tried either to increase to 200mg vaginally or when I lowered my Lenzetto during the Utro phase, both times I felt the Utro much more strongly and wasn't able to hack it - but it was only that I was extremely drowsy during the daytime. I haven't experienced Utro either helping me sleep at night or causing me insomnia though.
I completely understand not wanting to sway someone's decision, I'm also always reluctant to advise people as you can only go by your own experiences!
One other thing I noticed happen at the same time was that my testosterone level has halved from what it used to be - I always had testosterone at the top end of the range, although never had any high testosterone symptoms - I think it was just my natural state. But when I last had it tested in April it was half of what it used to be. I'm not sure if this could have been a result of the contraceptive Pills or HRT or whether it can affect weight etc.
So many different things going on... high cortisol, lowered testosterone, borderline low T4 and yet none of it pieces together to make any sense! The Lenzetto has been such a life saver for me it's just so upsetting having to still deal with these other symptoms and no idea how to fix them ???
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Ah, the 2 days of thyroxine were during the Utrogestan phase of your cycle. Reason for asking was, as mentioned earlier, Utrogestan makes me feel horribly hyper :o. I've had 4 trials of it with different doses of oestrogen, but have been unable to tolerate it each time. It feels to me as though it makes me markedly over-treated (with thyroid replacement). When I researched to see whether this could be the case, I came across a study that found progesterone increases free T4 levels. Small study & the effect was fairly modest, but it seems to confirm my sense that the worst of the side effects I get from Utrogestan are due to it potentiating my thyroid replacement intolerably. So I do wonder whether the same happened with you - that the Utrogestan was effectively magnifying the effects of the modest dose of thyroxine on top of what you're still making for yourself & that's perhaps what made you feel hyper. I should stress I'm basing this purely on personal experience & one small study.
I completely understand not wanting to sway someone's decision, I'm also always reluctant to advise people as you can only go by your own experiences!
Yes exactly - all we can do here is share personal experience/compare notes.
One other thing I noticed happen at the same time was that my testosterone level has halved from what it used to be . . . I'm not sure if this could have been a result of the contraceptive Pills or HRT or whether it can affect weight etc.
There is mention in the medical literature that hypothyroid women may be low in testosterone & that can be associated with weight gain & decreased energy.
Chronic constipation is a truly horrible thing to deal with & as you've tried everything in terms of diet etc, that must make you feel powerless. It's a symptom many hypothyroid patients really struggle with. All I can say is I follow a very high fibre GF diet including a weighed portion of prunes every day, drink lots of water & exercise daily. But if it turns out you do need thyroxine it should help you manage that symptom more easily.
I do hope you find a way forward & I completely understand your frustration & dismay. Always happy to chat about thyroid matters any time it might help & I'd be very interested to know how you get on with or without thyroxine. Whatever you do, I would try to get another TFT & thyroid antibodies tested, say 6 weeks after starting thyroxine if you continue with it, or maybe 3 months after last test if you don't, unless your Endocrinologst has advised otherwise of course. Do you have a follow-up appointment with him?
Wx
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How interesting on the Prog / thyroid link. I totally understand you're basing this on your own experience and research - that's the kind of thing I'm always cautious to say to others here, as none of us are experts! But I find it really helpful to hear of others experiences, and I have learnt SO much through this forum that has helped me... I actually have no idea where I would be had I not discovered it!
My Endo said to come back in 3 months which would be next month (though he thinks I've been taking the 25mg). I should say he actually prescribed me 50mg and said that anything less was almost a homeopathic dose and we would only know if my thyroid really was responsible by taking a 50mg dose, but after reading online that most people start at 25mg that's all I would feel comfortable taking anyway - I'm so annoyingly sensitive to all medications. I've had a couple of rubbish days of not great sleep so once that's back to being in a good place I'll probably give the 25mg another go and see how I get on.
The ONLY other thing I can think is that while 2 sprays of Lenzetto is clearly the amount of Estrogen I need not to be symptomatic, whether I'm just not getting enough Prog into my system to counteract it (I take 100mg vaginally for 12 days a month). I wonder if it's not so much the strength of the estrogen that's the issue (backed up by a blood test I had which showed a normal level on Lenzetto) but the lack of Prog to balance it out in the 2nd half of the cycle. I know that not much is absorbed systemically from the vaginal route, but I find it impossible to take Utro orally - I'm a zombie the next day! Even increasing to 200mg vaginally made me feel too tired!
Wrensong thanks ever so much for all your thoughts and input, it's really helped me - much appreciated ;D
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Glad the endocrinologist didn't discharge you. Yes, patients are often started on only 25mcg (micrograms), so that seems reasonable if you are very sensitive to meds. If he was expecting you to take 50mcg though, I would explain why you didn't ;D!
I hope you feel better for the thyroxine if you do decide to try it again. Bear in mind it can take quite a while to feel the benefits though. :)
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Your story sounds so much like mine. It feels like a long story but I’ll try to keep it as short as I can. (Rereading-I didn’t!)
I was in my late 30s and needed a Mirena to control post-coital bleeding. After about 3 years, I had some crazy roller coaster symptoms that in hindsight were peri menopause (but the drs said I was too young). I wanted off the roller coaster, so I went on the birth control pill, taken back to back (and for a few months, I still had the Mirena in place, until I was able to have it removed; the strings had gone inside). This seemed okay but I gained a tiny bit of weight and felt hungry often. I got engaged and decided to go on Weight Watchers (starting weight was 127 lbs; honestly they shouldn’t have let me join). WW absolutely messed up my relationship with food, causing restriction-binge cycles (because I just was not eating enough, and by the end of the week my body made up for it). I was getting chronic constipation, to the point that I saw a pelvic floor physiotherapist to see if she could help me (didn’t really get anything out of that).
Kept that up for a few months, then had enough. Went off the diet (at 122 lbs) and leaned into Intuitive Eating (which I recommend highly for anyone and everyone). In this, there is an understanding that you may gain weight (or lose it) while you reestablish hunger, fullness, and satisfaction cues. Just ride it out and let your body be, as difficult as it can be. So I did, and I ate lots of ice cream. Stopped forcing myself to exercise, and rested my body instead of punishing it/working out to “earn” food.
At this time, I was sick of decades of being in charge of birth control, so I convinced my partner to get a vasectomy, and I went off the pill. I got daily headaches for months and very rapid weight gain. Yes, I was being lazy and indulgent (for me), but this was otherworldly weight gain. Very very quick, and as you say, like a switch was flipped. I was hungry all the time (I attributed this to recovering from the diet restriction, but you know it was also the same feeling as that PMS craving, there’s not enough food feeling, primal hunger). Still constipated. I gained weight so quickly, I was alarmed and saw a dr. They found no issues with thyroid, but low ferritin, which was treated.
I kept thinking that once my period came, things would regulate; some weight would drop off. I read about how the pill can put your ovaries to sleep, so I tried to be patient. I wasn’t though. I pressed the dr, who once he saw my weight had climbed to 155 lbs in just a few months, ran all kinds of tests, a full thyroid panel, cortisol test, referral to endocrinologist, MRI. Nothing was ever out of range. But I looked and felt pregnant. People thought I WAS pregnant. I was always, always a waif, except when I was pregnant—I gained a lot of weight when pregnant, which I lost pretty easily.
Still no period. I saw another dr and asked for a course of Provera to reset/kick start my period. She said no, not until we run some tests. That’s when the early menopause diagnosis came, just before I turned 43. High FSH, repeated several times over several months.
I realized all the symptoms that I had that seemed like pregnancy or hypothyroid were menopause. I pressed for HRT, and started it eagerly. I continued to gain weight, up to 165lbs. So 127-165lbs in about 6 months. I was always tiny. I looked like a different person. I had to get all new clothes. I didn’t recognize myself.
I’ve been on HRT now for 2 years and things feel a lot better, but I think, in hindsight, a lot of symptoms were from too high estrogen. I have a Mirena again and use estrogel minimally (I have tried up to 4 pumps a day). I’m down to 142 lbs and feeling very well overall and happy with my relationship with food and exercise.
If I’m not mistaken, you were taking the pill back to back in an effort to overrride your own hormones, is that correct? I wonder if both of us really did put our ovaries to sleep, if that’s even a thing. I don’t have the answers, but I can relate so hard to having hypo symptoms but not testing as such. To getting some relief from HRT but feeling like metabolic rate has stopped dead.
I still wish I could flip the switch back, but after 3 years, this seems to be the new me.
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That’s so interesting Shannon. What dose of E do you use now?
Do you still have periods and in peri?
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I use just one pump Estrogel now, and as I felt like sometimes that was too much, I’m experimenting with following the actual directions of using it in cycles, so days 1-21 of a 28 day cycle, or days 1-25 of the calendar month. I do get a withdrawal bleed/spotting. I don’t think I get periods, but it feels like there is some background cycle at times, something in flux anyway. Because I’ve been on HRT over 2 years, I can’t “officially” say where I am in terms of peri vs post, and I’m unwilling to go without hormones for a full year just to satisfy criteria. Dr says my cervix shows signs of menopausal changes and that I need to be on at least one pump of estrogel. I played with all kinds of scenarios, hoping to get me back to my old self. I feel pretty close now, and generally quite well, but I think most of this weight is here to stay (and they say that’s a good thing, it’s protective in the long run; it’s the very slight ladies that suffer most with falls etc as they age).
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Hi Gilla999, sorry to hear that you are struggling.
You mention that perhaps your circulating oestrogen may be too high and I can certainly attest to the fact that if your oestrogen levels are too high (or too low) this can affect your ability to manage your weight effectively.
My weight gain is no doubt related to the change in hormones that happened as a result of being perimenopausal.
In my mid teens I went on the pill to help combat PMS inc cramping and quite heavy periods. I spent 20 odd years on the combined pill only to be told in my mid 30s that I couldnt have it any more. Within months of stopping it , i gained half a stone and bearing in mind I had not changed anything with the way I ate or my lifestyle. My skin also broke out too and I had what probably is termed adult acne. I tried various Progesterone only Pills (PoP) and products (the coil was the worst and I had gross amount of postulating spots and again weight was not manageable either). I stopped any form of contraceptive but spent about 5 years in the wilderness where I could not lose the weight gained and I would have breakouts in my skin.
FFWD to my early 40s and I was fed up. I had gone back on a low dose combined pill as I had given up smoking and my GP prescribed it as a way for me to manage my by then troublesome skin issue. That part worked and my skin was in control but other aspects of my self just werent right still - I just didnt believe I had to accept feeling and looking so bad. I decided to have one last ditch attempt at getting my body back. I approached a nutritionist who utilised a health nutrition and weight loss programme tailored specific to the individual and it worked. It was brilliant - I lost all of the weight, my skin was healthy and vibrant and I had sooooo much energy. This lasted for just over 2 years but then suddenly, I started noticing changes to my periods - I would get cramping for 2 weeks before having an actual period for 7 days (usually 4) which meant I had 3 weeks in a month of period related issues. I was having trouble managing the weight too and then in early 2020 the weight started to increase weekly - nothing I could do would stop it, even going back to basics with the tailored programme and, I just had relentless period like cramping. I then had confirmation that I was in perimenopause. I was desperate for help with this cramping which painkillers just did not touch. I approached a Dr at the surgery and he said that I would 'just have to get used to it and take painkillers daily' even though I told him they were not helping. I also started to notice many of the other symptoms like memory loss, irritability, anxiousness etc and this was all coupled with me taking on a more senior role and managing a team of employees.
Since then, I have been on a journey to find the right support for me - I cant tolerate oestrogen related hrt at the moment as not only do I appear to at times produce a lot, it goes down the wrong pathways (according to my dutch test) and manifest itself in oestrogen dominant like symptoms. A the moment I take only Utrogestan and I feel ok with that. I recently tried tailored Biest and boy did I have issues and felt awful with PMS like crazy and I thought I was going to have a period (not yet so far) so my body just cant seem to cope with it yet.
My weight just isnt shifting and I am the heaviest I have ever been in my life and as I am petite it is very obvious. I have had to buy new clothes as my job means I have to go on site at times and they are 2 sizes above my average clothes size. :(
My practitioner says that my oestrogen levels are going down in a zig zag fashion as in the last year alone I have had readings of over 800 (when I was using 1 pump of oestrogel) and as low as <18 (when I paused oestrogel).
The crux of this all is that my practitioner said that as the combined pill puts hormones to sleep, that once I stopped taking them my body needed time to adjust and it seems that essentially the default of my body was imbalanced hormonally anyway and would always have needed some kind of supplementation to balance it. But when peri hit it was the 'perfect storm' with the added stress of jobs, pandemic, coming off the pill in early forties and then shortly after going into peri menopause. :-\
So at the moment, I am trying to get balance of oestrogen vs progesterone and ensure oestrogen levels are sufficient so that I can lose weight. I have had a battery of tests done to try and understand my body more and from this, I should have clarity on how best to approach weight loss.
According to the practitioner I am working with Premenopausal transition is the hardest as hormones vary over time and what suits at one stage may be different to what is needed 6 months down the line which means probably some kind of regular hormone/blood test can be useful to gauge where individual levels are. She also said that the weight issue in menopause is the hardest to manage and least understood by our research to date. But there are people who do manage to lose and maintain weight in this stage of life - I just think keeping abreast of fluctuating individual levels and understanding them is probably key here :)
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Thank you LadyCC and Shannon for sharing your stories. I guess it goes to show the length that hormones can affect our weight - it's just so frustrating to not be able to pin down the exact cause. It seems like you both have similar stories about the Pill and weight gain when you came off it!
I was taking the pill back to back but only for 5 months before I gave up, but I know from hormone tests I had done while on the Pill that my own hormones weren't put to sleep - my own hormones were actually fluctuating like mad underneath and caused me to be very symptomatic with my night sweats and insomnia, which is why I ended up giving up on it and moving to Lenzetto, which has quite literally saved my life. I know I am ovulating as normal now, as I test every month. My sense (right or wrong) is that I have too much circulating estrogen not necessarily as a level in itself (because reducing it brings back my symptoms) but compared to the amount of Prog I am getting from 100mg Utro vaginally 12 days a month. I know the two are a delicate balance and that in a normal cycle Prog should be higher than Estrogen in the last part of your cycle and I wonder if that's just not happening with the amount I'm getting vaginally. The trouble is, taking more than 100mg, or taking it orally, makes me comatose - it's not liveable with!
Wrensong if you're still following - I posted on a thyroid forum about my test results and asked if you could still be symptomatic when in the low end of normal range, and the moderator replied yes and said he is extremely symptomatic when at the low (T4) end of the range and that the aim is always half the range as a minimum. So I definitely think it's worth me giving the 25mcg another shot to at least see how it goes. I do somewhat worry about how I'll be with it when it comes to the Utro stage, but we'll see. I wish there was some other natural alternative to Utro - but I bet I'm not alone in that wish!
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Gilla, yes that's right, hypothyroid patients reliant on prescription thyroid hormones often need to be in the upper half of the T4 ref range to feel well & I certainly did when younger & on thyroxine alone. But as you're making some thyroid hormone for yourself, converting what T4 you are making into the active form (your T3 is OK-ish) & your TSH is not raised, it gives a confusing picture in someone who's not yet on replacement. That's the dilemma for clinicians, whether to start treating a patient in your situation or not. Often they will wait until TSH is considerably raised before prescribing replacement. But your T4 is really quite low & at that level most people already on replacement (i.e whose thyroids have failed or been surgically removed) would probably have symptoms. The thing is, your thyroid may be producing more T4 than that sporadically - a test in someone not on replacement is only a snapshot.
But your Endocrinologist wouldn't have prescribed the thyroxine if he didn't think it a reasonable course of action, so if you feel you'd like to give it another go, that does make sense to me. I hope what I've written in this thread isn't confusing the issue for you - it's just that it's not straightforward & I think the more we understand, the more confident we can be in decisions about treatment. Would be irresponsible of me to point you one way or the other in a situation that's not black & white. But I'm very happy to thrash it out with you. :)
Absolutely agreed on the desirability of another natural alternative to Utro! I'd be elbowing you out of the way in the queue ;D
Wx
P.S. please don't worry about what I said earlier about my own reaction to Utro - I'm on T3 as well as T4 & the combination complicates management somewhat, meaning that my situation isn't typical. I can remember a former member on here who was on thyroxine with transdermal oestrogen & Utro with no problems. I was looking for an explanation for the hyper way you reported feeling on thyroxine so that's why I asked if the trial was when you were on the Utro phase. If you are at all anxious about taking new meds (as most of us are) that alone may explain your jitters on starting thyroxine. It's a low dose though - I was started on 25mcg nearly 3 decades ago before thyroid surgery & felt no difference whatsoever! Even when they put me straight on 100mcg after surgery I had no adverse effects.
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Thank you Wrensong, this is so helpful to know - I am sensitive to meds but I did think 2 days was quite quick to have a reaction on a low dose of 25mcg, and I wouldn't be surprised if my anxiousness compounds the sleep issue because I become hyper aware. I've decided to start taking it today and see how I go. Fingers crossed xxx
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OK Gilla. Glad you've been able to decide & really hope the thyroxine helps :). Please let us know how you get on :hug:
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Wrensong, I wondered if I could ask you in your experience how long it takes for thyroxine to work for your symptoms? Is it something that you notice straight away or is it a matter of weeks rather than days? I'm on day 6 today - I'm super glad I'm not having any negative side effects from it at least. Because that's what the Endo prescribed I may up it to 50mcg after a few weeks but will see how it goes!
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Hi Gilla - glad you've posted :). Sent you a PM a couple of days ago, asking how you were, but perhaps you never saw it. I often go quite a while without looking at the forum so if you ever have any worries it might help to chat about, please send me a PM as those come through to email so I'll know you're trying to get in touch.
Great that you're not having any side effects this time & well done for taking the plunge :foryou:. I know how scary it can be starting new meds. I wouldn't be surprised if you don't notice any difference in the short term as 25mcg is a pretty low dose & it will take time to reverse any systemic changes you may have had from possibly being mildly hypo for a while. I was on 25mcg for 5 months awaiting thyroid surgery & don't remember feeling any changes from that small dose, but it's possible I just wasn't that tuned in to my body & of course like yours, my thyroid was also still making some hormones at that stage.
These days I can usually feel a difference from a dose adjustment in 7-8 days, but that's probably because I'm wholly reliant on replacement to run my metabolism & after all this time, very attuned to symptoms. It takes 6-8 weeks before it's worthwhile repeating a TFT after any change of thyroid meds. Though my Endocrinologist likes to test after a month, I prefer to wait as levels are not stable with me in just 4 weeks.
Please don't worry if you don't feel any changes in the short term - it will be working quietly behind the scenes as it were! You will probably notice some difference after a while on 50mcg, I think. Can I ask how soon your Endo appt is?
Wx